RESUMEN
OBJECTIVE: To analyze the immediate and long-term results of simultaneous surgical treatment in patients with upper gastrointestinal cancer and cardiovascular diseases. MATERIAL AND METHODS: There were 9 patients with upper gastrointestinal cancer and cardiovascular diseases who underwent simultaneous surgical treatment. We assessed safety and efficacy of this approach. Mean age of patients was 65.7±5.7 years. Coronary artery disease was diagnosed in 3 patients, aortic valve disease - 1 patient, abdominal aortic aneurysm - 2; 4 patients suffered from isolated mitral valve disease, stenosis of the left vertebral artery, internal and external carotid arteries and Leriche syndrome. RESULTS: Considering immediate and long-term postoperative results, we can emphasize advisability of simultaneous surgeries in appropriate patients.
Asunto(s)
Estenosis de la Válvula Aórtica , Enfermedades Cardiovasculares , Enfermedad de la Arteria Coronaria , Neoplasias Gastrointestinales , Enfermedades de las Válvulas Cardíacas , Humanos , Persona de Mediana Edad , Anciano , Enfermedades Cardiovasculares/complicaciones , Enfermedades Cardiovasculares/diagnóstico , Enfermedad de la Arteria Coronaria/cirugía , Enfermedades de las Válvulas Cardíacas/cirugía , Válvula Mitral/cirugía , Neoplasias Gastrointestinales/complicaciones , Neoplasias Gastrointestinales/diagnóstico , Neoplasias Gastrointestinales/cirugía , Resultado del Tratamiento , Estenosis de la Válvula Aórtica/cirugíaRESUMEN
Hypertrophic cardiomyopathy (HCM) is the most common inherited disease, with a prevalence of 1:200 worldwide. The cause of HCM usually presents with an autosomal dominant mutation in the genes encoding one of more than 20 sarcomeric proteins, incomplete penetrance, and variable expressivity. HCM classically manifests as an unexplained thickness of the interventricular septum (IVS) and left ventricular (LV) walls, with or without the obstruction of the LV outflow tract (LVOT), and variable cardiac arrhythmias. Here, we present a rare case of mixed cardiomyopathy (cardiac hypertrophy and dilation) and erythrocytosis in a young patient. A 27-year-old man was admitted to the clinic due to biventricular heart failure (HF) NYHA class III. Personal medical records included a diagnosis of dilated cardiomyopathy (DCM) since the age of 4 years and were, at the time, considered an outcome of myocarditis. Severe respiratory infection led to circulatory decompensation and acute femoral thrombosis. The combination of non-obstructive LV hypertrophy (LV walls up to 15 mm), LV dilatation, decreased contractility (LV EF 24%), and LV apical thrombosis were seen. Cardiac MRI showed a complex pattern of late gadolinium enhancement (LGE). Endomyocardial biopsy (EMB) revealed primary cardiomyopathy with intravascular coagulation and an inflammatory response. No viral genome was detected in the plasma or EMB samples. Whole exome sequencing (WES) revealed a homozygous in-frame deletion p.2711_2737del in the MyBPC3 gene. The clinically unaffected mother was a heterozygous carrier of this deletion, and the father was unavailable for clinical and genetic testing. Essential erythrocytosis remains unexplained. No significant improvement was achieved by conventional treatment, including prednisolone 40 mg therapy. ICD was implanted due to sustained VT and high risk of SCD. Orthotopic heart transplantation (HTx) was considered optimal. Early manifestation combined hypertrophic and dilated phenotype, and progression may reflect a complex genotype with more than one pathogenic allele and/or a combination of genetic diseases in one patient.
RESUMEN
Surgical treatment of a patient with primary sarcoma of pulmonary trunk is presented in the article. This rare disease is characterized by poor prognosis if early diagnosis and adequate surgical treatment are absent.
Asunto(s)
Neoplasias Pulmonares/cirugía , Arteria Pulmonar/cirugía , Sarcoma/cirugía , Neoplasias Vasculares/cirugía , Diagnóstico Precoz , Humanos , Arteria Pulmonar/patología , Sarcoma/diagnóstico , Neoplasias Vasculares/diagnósticoAsunto(s)
Carcinoma Hepatocelular , Atrios Cardíacos , Hepatectomía/métodos , Neoplasias Hepáticas , Hígado , Trombectomía/métodos , Vena Cava Inferior , Carcinoma Hepatocelular/patología , Carcinoma Hepatocelular/cirugía , Puente Cardiopulmonar/métodos , Paro Cardíaco Inducido/métodos , Atrios Cardíacos/diagnóstico por imagen , Atrios Cardíacos/patología , Atrios Cardíacos/cirugía , Humanos , Hígado/diagnóstico por imagen , Hígado/cirugía , Neoplasias Hepáticas/patología , Neoplasias Hepáticas/cirugía , Masculino , Persona de Mediana Edad , Invasividad Neoplásica , Estadificación de Neoplasias , Resultado del Tratamiento , Neoplasias Vasculares/patología , Neoplasias Vasculares/secundario , Neoplasias Vasculares/cirugía , Vena Cava Inferior/diagnóstico por imagen , Vena Cava Inferior/patología , Vena Cava Inferior/cirugíaAsunto(s)
Aorta Abdominal/cirugía , Enfermedades de la Aorta/cirugía , Obstrucción Intestinal/cirugía , Trombosis/cirugía , Procedimientos Quirúrgicos Vasculares/métodos , Enfermedad Aguda , Aorta Abdominal/diagnóstico por imagen , Enfermedades de la Aorta/complicaciones , Enfermedades de la Aorta/diagnóstico por imagen , Humanos , Obstrucción Intestinal/complicaciones , Masculino , Persona de Mediana Edad , Trombosis/complicaciones , Trombosis/diagnóstico por imagen , Tomografía Computarizada EspiralRESUMEN
We propose and tested a method for studies of native blood cells by atomic-force microscopy in a humid chamber preserving viability, size, and shape of biological objects. The method has some advantages over scanning in a liquid cell: it allows studying non-fixed blood samples in the form of suspension of live cells and excludes mechanical and chemical influences on the cells.